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DR. MARIO L.P. GALLARDO M.D.
NPI 1285635201
Internal Medicine in Whiting, NJ

Active since August 02, 2005PECOS EnrolledAccepts Medicare Assignment
65 LACEY RD, SUITE A, WHITING, NJ 08759(732) 350-0404(732) 350-2001 Get Directions Write a Review

NPPES record last updated: July 3, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Mario L.p. Gallardo M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARIO L.P. GALLARDO M.D. (NPI 1285635201) is an individual internal medicine provider in Whiting, New Jersey, licensed in New Jersey (25MA06246300) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Community Medical Center, and is a graduate of Other (1987).

NPPES Registry Identity

NPI1285635201
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. MARIO L.P. GALLARDOCredential: M.D.
Location Address65 LACEY RD, SUITE AWhiting, NJ 08759-2985
Mailing Address65 Lacey Rd, Suite AWhiting, NJ 08759-2985 · (732) 350-0404 · Fax (732) 350-2001
Phone(732) 350-0404
Fax(732) 350-2001
Sole ProprietorNo
Medical School CMSOtherGraduated 1987
Enumeration DateAugust 2, 2005
Last NPPES UpdateJuly 3, 2012
✔ NPI 1285635201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · 25MA06246300
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
65 LACEY RD, Whiting, NJ 08759
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Other Identifiers 3

Medicare ID-Type Unspecified780469N9NNJ
Medicare UPING07442NJ
Medicaid6683002NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mario L.p. Gallardo M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052347333
PECOS Enrollment IDI20050711000097
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
468 services230 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
362 services201 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
221 services221 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
134 services94 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
88 services87 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
85 services84 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Community Medical Center

Acute Care Hospitals · Toms River, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310041
Location99 Rt 37 WestToms River, NJ 08755 · Ocean County
Emergency services Birthing friendly

Monmouth Medical Center-Southern Campus

Acute Care Hospitals · Lakewood, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310084
Location600 River AveLakewood, NJ 08701 · Ocean County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08759 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$140.34 typical visit price
range $61.59 – $185.05
Typical copayment $35.08 (range $15.39 – $46.26)
Most-billed visit code 99204
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
12 suppliers33 claims80 services$6.36 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers16 claims18 services$1.16 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers27 claims31 services$207.03 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CRISNOEL CERVANTES M.D.
Internal Medicine
65 LACEY RD, SUITE A
WHITING, NJ 08759
Ocean County (732) 350-0404
DR. VICENTE MARTINEZ MAGSINO JR. M.D.
Internal Medicine
65 LACEY RD, SUITE A
WHITING, NJ 08759
Ocean County (732) 350-0404
DR. DONALD ANTHONY CARUSO M.D.
Internal Medicine
65 LACEY RD, SUITE A
WHITING, NJ 08759
Ocean County (732) 350-0404

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mario Gallardo's NPI number?

The NPI number for Mario Gallardo is 1285635201. It was assigned to this individual provider in the NPPES registry on August 2, 2005.

Where is Mario Gallardo located?

Mario Gallardo practices at 65 Lacey Rd Suite A, Whiting, NJ 08759. The listed phone number is (732) 350-0404.

What is Mario Gallardo's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mario Gallardo enrolled in Medicare?

Yes. Mario Gallardo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mario Gallardo accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Mario Gallardo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mario Gallardo affiliated with any hospitals?

According to CMS data, Mario Gallardo is affiliated with Community Medical Center and Monmouth Medical Center-Southern Campus.

When was this NPI record last updated?

The NPPES record for Mario Gallardo was last updated on July 3, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.